Department of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne de Flandre, CHRU, 59037 Lille, France.
Reprod Biomed Online. 2010 Feb;20(2):280-5. doi: 10.1016/j.rbmo.2009.11.010. Epub 2009 Dec 3.
Susceptibility of the ovarian reserve to chemotherapy is highly variable from one patient to another and poorly documented. To better characterize the evolution of follicular depletion in patients treated for lymphoma, serum anti-Müllerian hormone (AMH) assay was used. A total of 30 young women (mean age 24years) were prospectively recruited before initiation of chemotherapy for lymphoma. They were assigned either to an adriamycin, bleomycin, vinblastine and dacarbazine protocol (ABVD group) or to a protocol that included cyclophosphamide (non-ABVD group). AMH assays were performed before and during chemotherapy, and then every 3months after the end of treatment for a period of 1year. In all patients, AMH concentrations fell drastically just after the start of chemotherapy and were close to the detection limit at the end of the treatment. In the ABVD group, AMH concentrations increased from the third month after the end of chemotherapy and returned to pretreatment values 12months after the end of chemotherapy. Conversely, no significant change was observed in the non-ABVD group throughout the follow-up period. In conclusion, longitudinal analysis of AMH during chemotherapy highlights differences between protocols that could contribute to an understanding of ovarian toxicity and, ultimately, be useful in fertility preservation counselling.
卵巢储备对化疗的敏感性在个体间差异很大，且记录不佳。为了更好地描述淋巴瘤治疗患者滤泡耗竭的演变，我们使用了血清抗苗勒管激素（AMH）检测。共前瞻性招募了 30 名年轻女性（平均年龄 24 岁），在开始接受淋巴瘤化疗前入组。她们被分配到阿霉素、博来霉素、长春碱和达卡巴嗪方案（ABVD 组）或包括环磷酰胺的方案（非 ABVD 组）。在化疗前和化疗期间以及治疗结束后每 3 个月进行一次 AMH 检测，持续 1 年。在所有患者中，AMH 浓度在化疗开始后急剧下降，在治疗结束时接近检测限。在 ABVD 组中，AMH 浓度在化疗结束后第三个月开始增加，并在化疗结束后 12 个月恢复到治疗前水平。相反，在整个随访期间，非 ABVD 组均未观察到显著变化。总之，化疗期间 AMH 的纵向分析突出了方案之间的差异，这可能有助于理解卵巢毒性，并最终在生育力保存咨询中发挥作用。
